The efficacy of angiotensin-converting enzyme inhibitors in preventing postoperative tendon adhesion formation: An experimental study in rats.

OBJECTIVE: The aim of this study was to investigate the efficacy of angiotensin-converting enzyme inhibitors (ACEIs) in preventing postoperative tendon adhesion formation in a rat model of Achilles tendon repair. METHODS: In this study, 60 Sprague-Dawley male rats weighing 300 to 350 g were used. Rats were randomly divided into six groups (n = 10 per group): control-1, control-2, sham-1, sham-2, experiment-1, and experiment-2. The same surgical procedure was performed in all rats; a full thickness Achilles tenotomy was performed, and the tendon was repaired using a modified Kessler suture. Enalapril (10 mg/kg/day) was orally given to the Experiment-1 and Experiment-2 groups for three and six weeks, respectively. Thirty rats were sacrificed at three weeks (Control-1, Sham-1, Experiment-1); the remaining 30 rats were sacrificed at six weeks (Control-2, Sham-2, Experiment-2). Then, macroscopic, biomechanical, and histologic investigations were performed. RESULTS: Adhesion degree was found macroscopically lower in the Experiment-1 and 2 groups than others. In the histologic examination, the fibrosis level was found the lowest in the Experiment-2 group. Biomechanical evaluation indicated that mean maximum resistance before tendon rupture was significantly higher in the Experiment-2 group than in other groups. CONCLUSION: Evidence from this study has shown that ACEIs can decrease fibrosis and tendon adhesion during tendon recovery in rats due to their antifibrotic effects as the result of Angiotensin-II suppression.

Evaluation of clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis.

OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a common obesity-related comorbidity in childhood. In this study, we aimed to evaluate predictors of NAFLD by comparing clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis. METHODS: Two hundred and eight obese children aged 6-18 years were included. The patients were divided into group 1 (patients with NAFLD, n=94) and group 2 (patients without NAFLD, n=114). Anthropometric measurements, pubertal stage, lipid profiles, fasting glucose and insulin, homeostatic model of assessment for insulin resistance (HOMA-IR), uric acid, total bilirubin, alanine aminotransferase (ALT), blood urea nitrogen, thyroid-stimulating hormone and free thyroxine parameters were compared retrospectively. RESULTS: The mean body weight, body mass index (BMI), height, tri-ponderal mass index (TMI), insulin, HOMA-IR, triglyceride, ALT and uric acid values were significantly higher, while high-density lipoprotein-cholesterol (HDL-C) values were significantly lower in group 1. The 70.7% of obese children with hepatosteatosis and 83.9% of those without hepatosteatosis were correctly estimated by parameters including age, gender, ALT, HDL-C, fasting insulin and uric acid values. CONCLUSIONS: Since obesity-associated hepatosteatosis induces various long-term metabolic impacts in children, early detection is of critical importance. Age, gender, TMI, BMI, ALT, HDL-C, fasting insulin and uric acid values may help to predict the risk of hepatosteatosis. Besides, we assessed whether TMI compared to BMI does not have a better utility in estimating obesity-induced hepatosteatosis in children. This is the first study to show the association between TMI and hepatosteatosis in children.

Publication Patterns of Presentations at the 16th Quadrennial Meeting of the World Society for Stereotactic and Functional Neurosurgery.

BACKGROUND: The quality of a scientific meeting can be quantified by the rate of full publications arising from the presented abstracts and the impact factor of the journals in which the studies were published. OBJECTIVES: The aim of this study was to investigate the publication rates of presentations from the 2013 World Society for Stereotactic and Functional Neurosurgery (WSSFN) quadrennial meeting. METHODS: Scopus and PubMed databases were searched for the authors of the presentations to identify full publications arising from the relevant abstracts. Author and content matching were used to match an abstract with a full publication. Mann-Whitney U and Kruskal-Wallis tests were used for statistical analysis. RESULTS: In total, 77% (57/74), 56% (44/79), and 50% (79/157) of the paper, flash, and poster presentations, respectively, have been published, with an overall publication rate of 58% (180/310). Articles received a total of 5,227 citations, with an average of 29 ± 64.1 citations per article. The first authors who published their studies had a significantly higher h-index than those who did not publish (p = 0.003). The most preferred journals for publication were Journal of Neurosurgery, Acta Neurochirurgica, and Stereotactic and Functional Neurosurgery. The majority of the articles (117/180 [65%]) were published in a quartile 1 or 2 journal. The average journal impact factor (JIF) was 4.5 for all presentations, and 7.8 for paper session presentations. Studies presented in paper sessions were published in significantly higher-impact factor journals than those presented in poster sessions (p < 0.001). CONCLUSIONS: The WSSFN Congress had a relatively high overall publication rate (58%) compared to both other neurosurgical congresses and congresses in other scientific fields. The average JIF of 7.8 is a reflection of the high quality and high impact of the paper session presentations.

Excess Mortality in Istanbul during Extreme Heat Waves between 2013 and 2017.

Heat waves are one of the most common direct impacts of anthropogenic climate change and excess mortality their most apparent impact. While Turkey has experienced an increase in heat wave episodes between 1971 and 2016, no epidemiological studies have examined their potential impacts on public health so far. In this study excess mortality in Istanbul attributable to extreme heat wave episodes between 2013 and 2017 is presented. Total excess deaths were calculated using mortality rates across different categories, including age, sex, and cause of death. The analysis shows that three extreme heat waves in the summer months of 2015, 2016, and 2017, which covered 14 days in total, significantly increased the mortality rate and caused 419 excess deaths in 23 days of exposure. As climate simulations show that Turkey is one of the most vulnerable countries in the Europe region to the increased intensity of heat waves until the end of the 21st century, further studies about increased mortality and morbidity risks due to heat waves in Istanbul and other cities, as well as intervention studies, are necessary.

Mapping of carbon monoxide related death risk in Turkey: a ten-year analysis based on news agency records.

BACKGROUND: Carbon-monoxide (CO) poisoning is a substantial cause of preventable mortality. In Turkey, no nationwide data are being collected nowadays. In our study, we aimed to assess the trend in deaths related to CO exposure in all provinces of Turkey in a 10-year period by using the records of a news agency which collects the news from the majority of the national newspapers, local newspapers and television channels. METHODS: In this study, 27,881 news items that were released between January 2008 to December 2017 which included keywords of "poisoning" and "death" or "carbon monoxide" and "death" were evaluated. 2667 non-fire related deaths were used in the final analyses. RESULTS: In a 10-year period, the risk of CO-related death in Turkey was 0.35/100000. 1371 (51.4%) of the victims were male and the median age of the patients was 45 years (range, 15 days-108 years). Most of the deaths occurred ≥50 years of age. Stoves were the predominant source [n = 2096 (78.6%)]. There was a stagnating trend of CO-related deaths. Most of the incidents occurred in winter. The Middle Anatolian region was of the highest risk in CO-related mortality. CONCLUSIONS: In conclusion, CO poisoning is still a considerable public health concern in Turkey. Results of our study showed that stoves are still frequently being used and are the cause of death especially in rural areas with lower socioeconomic status. A better organized, nationwide surveillance and management approaches are needed to demonstrate the true burden CO related morbidity and mortality as well as its prevention in Turkey.